Provider Demographics
NPI:1780628644
Name:PAYNE, KRISTYN WARKEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTYN
Middle Name:WARKEN
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTYN
Other - Middle Name:ANNE
Other - Last Name:WARKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9303 PINECROFT DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3180
Mailing Address - Country:US
Mailing Address - Phone:281-363-5050
Mailing Address - Fax:281-363-5020
Practice Address - Street 1:9303 PINECROFT DR
Practice Address - Street 2:SUITE 150
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3180
Practice Address - Country:US
Practice Address - Phone:281-363-5050
Practice Address - Fax:281-363-5020
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2443207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7941899OtherAETNA
P00455498OtherRAILROAD MEDICARE
TX8J5522OtherBLUE CROSS BLUE SHIELD
7941899OtherAETNA
I66638Medicare UPIN